Premier Dental Group Hi INC

Premier Dental Group Hi INC was paid $23K by Medicaid between Feb 2018 and Oct 2024, across 9 billing codes. Its largest line is D1110, Prophylaxis - adult — 42% of everything it billed.

33Billing provider infoPREMIER DENTAL GROUP HI INC
AIEA, HI 96701

33aNPI1407395668assigned 02/21/2017

33bProvider typeGeneral Practice Dentistry

28Total paid$23K

24GClaims601

24DCodes billed9

24AFirst – last monthFeb 2018 – Oct 2024

Compared with peers

Next to other General Practice Dentistry providers in Hawaii

Rank by total paid#37 of 63

Median peer was paid$33K

This provider vs. median0.7×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	88	$3K
2019	172	$5K
2023	82	$4K
2024incomplete	259	$11K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	42%	194	194	$10K
D0140	Limited oral evaluation - problem focused	17%	104	103	$4K
D1206	Topical application of fluoride varnish	11%	118	118	$2K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	8.8%	55	55	$2K
D9310		8.4%	26	26	$2K
D0210	Intraoral - complete series of radiographic images	4.6%	14	14	$1K
D0220	Intraoral - periapical first radiographic image	3.8%	56	54	$883.12
D1120	Dental cleaning, childProphylaxis - child	2.8%	19	19	$639.92
D0150	Comprehensive oral evaluation - new or established patient	2.4%	15	15	$564.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialTAKAKI, GLENN (PRESIDENT)